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Background: Critical pathways (CPs) are now used throughout the world. Despite their prevalence, many issues relating to clinical pathways in China remain unsettled. Therefore, it is necessary to evaluate the application of CPs quality.

Objectives: In the current study, the authors aim to focus on the methodological quality of clinical pathways between 2014 to 2016 in China.

Methods: We searched the Chinese Biomedical Database (CBM), China National Knowledge Infrastructure (CNKI), and the Wanfang Database from inception to February, 2017 to include the Clinical pathways in China. We evaluated methodological quality of clinical pathways with Integrated Care Pathway Appraisal Tool (ICPAT). The ICPAT including 25 items as a quality assurance tool which provides senior trust staff with a framework for developing CPs.

Results: There are 84 CPs published in journals were included. 83.3% (7/84) CPs didn't consider clinical risk as part of the content of the CPs, 3.57% (3/84) CPs test the ICP and audit the CPs documentation after the pilot; 94% (79/84) ICPs indicate the circumstances when a patient should come off or should not be put on (exclusion criteria) and 92.9% (78/84) CPs record the rationale for including and excluding pieces of evidence/guidelines. However, none of them conduct a literature search to gather the evidence base for the CPs and consider training of staff as part of the content; 3.52% (3/84) conducted a literature search and 30% (7/27) pilot test after the pilot.

Conclusions: Our study demonstrated that the methodological quality of clinical pathways in China was low, more efforts should be done to improve the methodological quality of clinical pathways in China.